Motivation zur psychosomatisch-psychotherapeutischen Bearbeitung von beruflichen Belastungen - Entwicklung und Validierung eines Fragebogens
Background There is a lack of questionnaires assessing the motivation of inpatients to scrutinize occupational stresses and deal with them as part of their psychotherapeutic treatment. Work-related stress contributes significantly to the development of mental disorders. Vocational reintegration is an outcome criterion for the success of vocational rehabilitation. Patients are often not motivated for dealing with occupational stresses during inpatient medical rehabilitation. Therefore it is necessary to assess patient motivation at the beginning of treatment, in order to assign them to specific interventions, e. g. promoting motivation. Method A questionnaire (Fragebogen zur berufsbezogenen …
Changes in quality of life in visually impaired patients after low-vision rehabilitation.
The objective of the study was to assess the impact of low-vision aids on quality of life. Interviews included a modified version of the National Eye Institute Visual Functioning Questionnaire (Modified German NEI VFQ-25), the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination Blind, and Indicators of the Rehabilitation Status. These were conducted before and 5 months after low-vision rehabilitation that involved recommendation of devices and instructing patients on how to use them. Of a total of 88 patients interviewed before low-vision rehabilitation, 50 patients could be reached for the follow-up interview. A huge proportion of the sample reported clinically signifi…
Persönlichkeitsdiagnostik in der Online-Psychotherapieforschung
Zusammenfassung. Zunehmend wächst das Angebot evidenzbasierter psychotherapeutischer Online-Interventionen. Dies wirft die Frage auf, ob bestimmte Persönlichkeitsmerkmale Nutzung und Erfolg von onlinebasierten Interventionen beeinflussen. Erste Befunde liefern Hinweise, dass sich breite (z.B. Offenheit für neue Erfahrungen, Gewissenhaftigkeit) sowie spezifische Traits (z.B. Einstellung zu psychotherapeutischen Online-Interventionen) als relevante Prädiktoren erwiesen. Trotz der bislang limitierten Datenlage für differentielle Effekte bei klinischen Stichproben stellen Persönlichkeitsmerkmale für die vielen möglichen Varianten der Online-Psychotherapie bei verschiedenen Störungsbildern eine…
The impact of attachment distress on affect-centered mentalization: An experimental study in psychosomatic patients and healthy adults
Introduction We investigated the impact of attachment distress on affect-centered mentalization in a clinical and a non-clinical sample, comparing mentalization in a baseline condition to mentalization under a condition of attachment distress. Methods The sample consisted of 127 adults who underwent inpatient psychosomatic treatment, and 34 mentally healthy adults. Affect-centered mentalization was assessed by analyzing participants’ narratives on interpersonal situations in a baseline condition with the Levels of Emotional Awareness Scale (LEAS), and an experimental condition inducing attachment distress with the Adult Attachment Projective Picture System (AAP). Unlike the LEAS, the AAP is…
Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population.
Abstract Background Recently, the two item version of the Cambridge Depersonalization Scale (CDS-2) has been validated in a clinical sample and has demonstrated that it is a useful tool for the detection of clinically significant depersonalization (DP). In order to provide a framework for the interpretation of the CDS-2 scores the aim of this study was to achieve normative data of a representative sample of the German population and to evaluate the associations with depression, anxiety and sociodemographic characteristics. Methods A nationally representative face-to-face household survey was conducted during the mid of 2009 in Germany. The sample comprised N = 2512 participants. The survey …
An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial
Abstract Background A cancer diagnosis can cause severe emotional distress and affect quality of life as well as social relationships. The transition from inpatient to outpatient treatment is burdened by stressful uncertainties and a gap of psycho-oncological care. In addition, further barriers, such as information deficits or fear of stigmatization, might hinder cancer patients to use psycho-oncological face-to-face interventions. Online interventions can be a low-threshold adjunct to existing face-to-face services. This study aims to evaluate the effect of the online self-help program epos (emotion-based psycho-oncological online self-help) on improving symptoms of anxiety and depression …
Implementation of a Web-Based Work-Related Psychological Aftercare Program Into Clinical Routine: Results of a Longitudinal Observational Study
Background: As inpatient medical rehabilitation serves to promote work ability, vocational reintegration is a crucial outcome. However, previous Web-based trials on coping with work-related stress have been limited to Web-based recruitment of study participants. Objective: The aim of our study was to evaluate the implementation of an empirically supported transdiagnostic psychodynamic Web-based aftercare program GSA (Gesund und Stressfrei am Arbeitsplatz [Healthy and stress-less at the workplace])-Online plus into the clinical routine of inpatient medical rehabilitation, to identify characteristics of patients who have received the recommendation for GSA-Online plus, and to determine helpfu…
Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial
Background We recently showed in a randomized controlled trial that Web-based self-help as an adjunct improved the effectiveness of multimodal inpatient psychotherapy for depression. Objective The aims of this study were (1) to determine whether a Web-based self-help adjunctive to multimodal inpatient psychotherapeutic treatment could also improve the course of depressive symptoms and (2) to identify predictors of residual depressive symptoms at follow-up. Methods Overall, 229 patients were randomized either to the Web-based self-help intervention group (Deprexis) or an active control group (Web-based information about depression and depressive symptoms) in addition to multimodal inpatient…
Soziale Phobie – eine im psychosomatischen Ambulanz- und Konsildienst unterdiagnostizierte Angsterkrankung?
Social fears are common, whereas Social Phobia is diagnosed infrequently. Therefore, we compared the clinical diagnoses (ICD-10) in an outpatient and CL service of a psychosomatic university hospital to patients' self ratings in social fears on the Liebowitz Social Anxiety Scale (LSAS). Over the course of one year 688 patients could be characterized regarding their clinical diagnoses, LSAS-scores, symptom severity (SCL-90R) and psychosomatic complaints (GBB-24). Patients were assigned to three groups by their levels of social fears (LSAS). Social Phobia was diagnosed rarely by clinicians (5.5%), but generalized social fears (LSAS>60) were commonly reported by patients (14.6%). Patients with…
„Morbus Google“ vs. e-Health: Qualitative Untersuchung zur Akzeptanz und Implementierung von Online-Nachsorge in der stationären Rehabilitation
Zusammenfassung Hintergrund Internet- und mobilbasierte Gesundheitsinterventionen (IMIs) können z. B. in Form von Nachsorgeangeboten das Behandlungsangebot der Rehabilitation erweitern. Für die Implementierung ist jedoch deren Akzeptanz eine wesentliche Voraussetzung, die daher bei Rehabilitanden und Mitarbeitern qualitativ untersucht wurde. Methodik In 3 Rehabilitationskliniken mit verschiedenen Indikationen und Altersgruppen wurden n=15 Rehabilitanden in Einzelinterviews und n=29 Mitarbeiter verschiedener Berufsgruppen in Fokusgruppen nach einem semi-strukturierten Leitfaden auf Basis der “Unified Theory of Acceptance and Use of Technology“ interviewt. Ergebnisse Vorteile einer Online-Nac…
Ungesunder Lebensstil bei Patienten einer psychosomatischen Poliklinik und Konsilambulanz
Patienten mit psychischen Storungen haben ein hoheres Risiko fur die Entwicklung korperlicher Erkrankungen. Als wesentlicher Risikofaktor hierfur gilt ein ungesunder Lebensstil. Um praventive Ansatzpunkte zu finden, untersuchten wir, wie haufig ein ungesunder Lebensstil bei psychosomatischen Patienten vorkommt und wie dieser mit psychischen und somatischen Beschwerden zusammenhangt. Hierzu wurde die klinische Basisdokumentation der Jahre 2009–2011 von n=1 919 ambulanten psychosomatischen Patienten ausgewertet. Korperliche Inaktivitat war mit 62,4% das haufigste Lebensstilrisiko, gefolgt vom Rauchen (33,2%) und Adipositas (17,4%). Alle Lebensstilrisiken waren mit einer hoheren Symptombelastu…
Vocational training integrated into inpatient psychosomatic rehabilitation--short and long-term results from a controlled study.
Purpose. The aim of this study was to determine the impact of a vocational training programme on short- and long-term results after psychosomatic rehabilitation. Method. 1,590 inpatients were screened for vocational integration. A high-risk group of 266 patients was randomly assigned to the vocational training programme plus psychosomatic treatment; treatment- as- usual served as a control condition. An occupational training was conducted at local companies, closely integrated into psychosomatic treatment. Vocational attitudes and adjustment were studied at intake, discharge, three, 12 and 24 month follow-ups. Results. More than half of the study participants were unemployment and/or long-t…
Einstellungen von Medizinstudierenden zu psychotherapeutischen Behandlungsverfahren und Weiterbildungen
Zusammenfassung Hintergrund und Fragestellung: Vor dem Hintergrund einer arztlichen Unterversorgung von Patienten mit psychischen und psychosomatischen Erkrankungen gewinnt die Frage nach dem Interesse von Studierenden der Medizin fur psychische Erkrankungen und ihren Einstellungen zu psychotherapeutischen Behandlungsverfahren beziehungsweise dem Erwerb des Facharzttitels in diesen Fachgebieten an Bedeutung. Methode: Studierende der Medizin (N = 366) im klinischen Ausbildungsabschnitt wurden mit teilstandardisierten Fragebogen zu ihren Interessen und Einstellungen gegenuber psychotherapeutischen Behandlungsverfahren, zu ihren beruflichen Planen, zu psychischen und sozialen Belastungen sowie…
Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach.
<b><i>Background:</i></b> Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. <b><i>Methods:</i></b> A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online inf…
Entwicklung einer psychosozialen Online-Selbsthilfe für Krebspatienten: ein patientenorientierter Ansatz
Zusammenfassung Ziel der Studie Der Einbezug potenzieller Endnutzerinnen und -nutzer in den Entwicklungsprozess digitaler Interventionen ermöglicht, dass entwickelte Programme den Bedürfnissen, Anforderungen und Erwartungen der zukünftigen Nutzerinnen und Nutzer entsprechen, was sich wiederum positiv auf die Akzeptanz und Adhärenz auswirkt. In diesem Beitrag wird ein partizipativer Entwicklungsansatz für die patientennahe Gestaltung der psychoonkologischen Online-Selbsthilfe epos vorgestellt, welche Unterstützung im Umgang mit seelischen und körperlichen Beschwerden bieten soll. Methodik Patientinnen und Patienten wurden an 2 Stellen in den Entwicklungsprozess einbezogen. Zu einem frühen Ze…
Ready for eHealth? Health Professionals' Acceptance and Adoption of eHealth Interventions in Inpatient Routine Care.
eHealth interventions can be effective in treating health problems. However, adoption in inpatient routine care seems limited. The present study therefore aimed to investigate barriers and facilitators to acceptance of eHealth interventions and of online aftercare in particular in health professionals of inpatient treatment. A total of 152 out of 287 health professionals of various professional groups in four inpatient rehabilitation facilities filled out a self-administered web-based questionnaire (response rate: 53%); 128 individuals were eligible for further data analysis. Acceptance and possible predictors were investigated with a complex research model based on the Unified Theory of Ac…
Prevalence, correlates, and predictors of depersonalization experiences in the German general population.
The survey aimed to investigate the prevalence of depersonalization (DP) experiences, its sociodemographic characteristics and its associations with medical conditions, illness behavior, and potential etiologic factors. A representative face-to-face household survey was conducted. The sample consists of n = 1,287 participants aged 14 to 90 years. Sociodemographic variables, medical conditions, current mental disorders, health care utilization, and childhood adversities were assessed. A total of 1.9% participants scored in the range of clinically significant DP (DP-C) and 9.7% reported at least some impairment through DP (DP-I). DP-C/DP-I were strongly associated with depression and anxiety.…
Psychodynamic Online Treatment Following Supportive Expressive Therapy (SET):Therapeutic Rationale, Interventions and Treatment Process.
The feasibility of psychodynamic online treatments has remained an issue of debate. The paper presents rationale and technique of a psychodynamic online intervention discussing therapeutic process and alliance based on two case examples from an RCT.A weekly writing task is followed by individual feedback from the online therapist. Treatment focuses on a 'Core Conflict Relationship Theme' based on relationship episodes according to the wish of the patient, reactions of the others and reactions of the self. Maladaptive interpersonal interactions are worked through by supportive and expressive therapeutic interventions.Case reports from our study illustrate a productive therapeutic process wit…
Retrospektiv berichtete Kindheitstraumatisierung und Gesundheitsverhalten im Erwachsenenalter von psychosomatischen Patienten
Zusammenfassung Fragestellung: Missbrauchserfahrung in der Kindheit ist mit physischen und psychischen Gesundheitsstorungen im Erwachsenenalter assoziiert. Auch wurde ein ungunstiger Einfluss auf das Gesundheitsverhalten festgestellt. Die vorliegende Studie knupft an diese Befunde an und untersucht den Einfluss verschiedener Formen der Kindheitstraumatisierung auf das Gesundheitsverhalten erwachsener psychosomatischer Patienten. Methode: Es wurde die klinische Basisdokumentation (2010–2013) von N = 2326 Patienten einerUniversitatsklinik fur PsychosomatischeMedizin und Psychotherapie ausgewertet.Kindheitstraumatisierung wurde mittels Childhood Trauma Questionnaire (CTQ) erfasst. Das Gesundhe…
Psychodynamic focal group treatment for psychosomatic inpatients--with an emphasis on work-related conflicts.
Conflicts arising from the work setting have remained a neglected issue in psychotherapy. To address this, the present study investigated the effectiveness of a manualized focal group treatment for psychotherapeutic inpatients suffering from vocational strains and conflicts and identified predictors of outcome. Cohorts of patients were assigned either to a treatment (N=144) or control condition (N=135). The group therapy intervention was found to be highly accepted by participants who were also more optimistic about returning to work and more favorable in their evaluations of treatment than patients in the treatment-as-usual condition. Group climate was found to be a predictor of favorable …
Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial.
BACKGROUND There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer. PATIENTS AND METHODS In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured C…
Erwartungen und Informationsbedarf von Rehabilitanden bezüglich stationärer psychosomatischer Rehabilitation
Zusammenfassung Ziel der Studie Um ein Online-Portal zur Vorbereitung auf die stationäre psychosomatische Rehabilitation zu entwickeln, wurden Informationsbedarf und Online-Nutzungsverhalten von Rehabilitanden untersucht. Methodik Vier Fokusgruppen mit Rehabilitanden (N=31) sowie zwei mit Behandlern (N=18) wurden durchgeführt und qualitativ-inhaltsanalytisch ausgewertet. Ergebnisse Insgesamt wurden 419 Aussagen von Rehabilitanden und 333 Aussagen von Behandlern kodiert und kategorisiert. Aktuelle Informationsmaterialien zur Rehabilitation wurden von Rehabilitanden als zu ausführlich und schwer verständlich eingeschätzt. Unsicherheit bestand vor allem hinsichtlich der Wirksamkeit und Nachhal…
Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients
Background: The aim of this longitudinal study was to determine age- and sex-standardised prevalence rates of cancer-related fatigue in different groups of patients. Methods: This was a prospective study in a cohort of N=1494 cancer patients investigating fatigue at three time points t1–t3 (t1: admission to hospital, t2: discharge, t3: half a year after t1). Fatigue was measured with the Multidimensional Fatigue Inventory. Age- and sex-adjusted norms were derived from a representative community sample of N=2037, using a cutoff at the 75th percentile. Results: At admission to the hospital, 32% of the patients were classified as fatigued. At discharge, the overall prevalence rate was 40%, and…